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Do Not Compare COVID-19 (Coronavirus) To Seasonal Influenza

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42pines specializes in Occupational Health; Adult ICU.

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Do You Think COVID-19 and Seasonal Influenza Compare?

Increased awareness and preparation in schools about Covid-19 You are reading page 2 of Do Not Compare COVID-19 (Coronavirus) To Seasonal Influenza. If you want to start from the beginning Go to First Page.

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1 minute ago, toomuchbaloney said:

The WHO has adjusted the CFR to 3+

And 0.7% outside of Wuhan.

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42pines specializes in Occupational Health; Adult ICU.

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On 3/2/2020 at 6:03 PM, myoglobin said:

They report (as of March 02 at 2:50PM Pacific, 2020) that there have been a total of 90,305 cases worldwide with 3085 deaths.  This would equate to a case fatality rate of around 3.41%. 

Correct, but misleading.  Simply stated: A case fatality rate of 3.41% stands only if every single case where the afflicted has not recovered, or died, will recover.

In other words, you are assuming that all remaining cases with unknown outcome will have no fatalities.

Nonetheless, my article's point is simply the "death" rate of the seasonal influenza over eight years is about one death in 750-1000 cases.

Using the 3.41% you have quoted means 34 deaths per 1,000 cases.

That means a death rate of about 34x that of the seasonal influenza.

Thus it is unwise for nurses to say: "oh, it's about the same as the flu."

On the other hand, the seasonal influenza has killed more this year already than has Covid-19 and we can lower that rate by immunization.  Both are important subjects for nurses.

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42pines specializes in Occupational Health; Adult ICU.

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On 3/2/2020 at 12:43 PM, Wuzzie said:

What are you thoughts on this?

https://www.facebook.com/michael.zapor

Note: See following post to read Zapor's statement.

It's a neat article and I enjoyed it.  It had some interesting sections:

"Because viral DNA has been isolated from respiratory secretions of exposed asymptomatic individuals, it is believed that not everyone who is exposed will become ill. The extent to which these individuals transmit SARS-CoV-2 to others is not yet known."

This is a potential "elephant in the room," unknown.  This may be the reason that we are now seeing community cases in America.

"The overall estimated case fatality rate (CFR) appears to be ~2.3%, making it less deadly than some influenza strains."

The CFR is only useful "looking-back."  To see what is occurring one must look at the death rate divided by the population with known outcome, meaning the population who have either recovered or died.  We simply don't know about the rest of those cases, nor do we know about cases that exist that are not confirmed cases.  I suspect that the eventual CFR will be between 3-4%, but that's a guess.

"To date, SARS-CoV-2 has shown itself to be a respiratory viral pathogen most commonly causing mild, self-limiting illness, with more severe disease limited to certain susceptible populations." 

That statement is correct.  It sounds quite mild, unless, of course, you are one of the 3,214 now dead.

This year's influenza season may kill more than Covid-19 does, it's been a harsh season, but eventually ~12-30 million Americans (based upon the past eight flu seanos) will have contracted the flu.

Should 12-30 million contract Covid-19, and if the fatality rate continues to be between 3-4% there could be 360,000 to 1,000,000 fatalities, which would be far worse than the typical flu season.

Could this happen?  Yes.  Might it not happen? Yes.  Warm weather could stop Covid-19 in its tracks, or it might mutate to a more benign form as the H1N1 pandemic of 2010 (Swine flu) did.

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26 minutes ago, Wuzzie said:

And 0.7% outside of Wuhan.

It will be interesting to see how a country with poor health care access and high rates of chronic disease will fare.

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42pines specializes in Occupational Health; Adult ICU.

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On 3/2/2020 at 6:03 PM, myoglobin said:

They report (as of March 02 at 2:50PM Pacific, 2020) that there have been a total of 90,305 cases worldwide with 3085 deaths.  This would equate to a case fatality rate of around 3.41%.  

Myoglobin, I enjoyed your post and you know your history.  I’ll only comment that, as most others do, you are not factoring in those cases that are “still out there, with undetermined outcome.”  The 3085/90,305 is indeed the CFR.  My point is that the CFR is only useful looking back after the epidemic has run its course.

Your numbers include those who have died + those who have recovered + about 35,000 cases whose outcome has yet been determined.  To accept your 3.41% ALL in that remaining group of ~35,000 must recover with zero deaths.  Do you think this is likely to happen?

We’re nurses, we like it when everyone survives. I suspect that some of those remaining 35,000 will not.  I’m sorry that I’m not quite the optimist.

I do agree completely about what I call, “unintended effects.”  China has become one of the world leaders in drug manufacturing, second to India.  Even where drugs are made in America, pharmaceutical feedstock or some of it comes from China.

Here’s an obscure fact.  ALL niacin (Vitamin B-3) is made in China.  You might think “big deal—so what?.” Well, how about this, “ALL” mean over 22,000 tonnes!  That’s 48 billion pounds.  Now, you’re apt to say: “I don’t use vitamins.”  My response would be: Did you have a sandwich for lunch today? (Most breads are enriched with B3)

Niacin shortages don’t bother me, but I do wonder about other supply line shortages for more critical med such as BP meds.

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Nurse SMS has 9 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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It will also be interesting to see what happens now that China has released findings of two different strains of the virus, with one believed to produce worse symptoms/outcomes than the other.

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42pines specializes in Occupational Health; Adult ICU.

1 Article; 282 Posts; 10,518 Profile Views

3 hours ago, Nurse SMS said:

It will also be interesting to see what happens now that China has released findings of two different strains of the virus, with one believed to produce worse symptoms/outcomes than the other.

Got a link Nurse SMS?  I'd like to see that.

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42pines, it seems that you have significant education/training in statistical methodology and epidemiology.  Your OP says that you specialize in Occupational Health, and I recall your OP also says that you have a degree in Chemistry.  Would you be willing to tell us about the education and courses you have taken, especially your education/training in statistics?  My understanding is that you are also a nurse.  Am I understanding correctly that you are an Occupational Health Nurse (or do you work in Occupational Health in another role) and also work in the ICU as a nurse?  How did you decide to enter the field of Occupational Health?

Edited by Susie2310

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Nurse SMS has 9 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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39 minutes ago, 42pines said:

Could this happen?  Yes.  Might it not happen? Yes.  Warm weather could stop Covid-19 in its tracks, or it might mutate to a more benign form as the H1N1 pandemic of 2010 (Swine flu) did.

It could potentially die down over the Summer and roar back in the Fall, as the Spanish Flu in 1918 did. Lots of "what's going to happen" going on.

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45 minutes ago, 42pines said:

The CFR is only useful "looking-back."  To see what is occurring one must look at the death rate divided by the population with known outcome, meaning the population who have either recovered or died.  We simply don't know about the rest of those cases, nor do we know about cases that exist that are not confirmed cases.  I suspect that the eventual CFR will be between 3-4%, but that's a guess.

Yes, you keep saying this but at this point I feel like I need to caution you to please remember that this may be a nursing forum but it is also open to a public who is already panicking about this subject. When you state death rates upwards of 30% you risk adding to their fear because they do not understand how you achieved that number.  As nurses I absolutely believe we have a responsibility to educate but we also need to be sensitive to the fact that our words carry power.  Your numbers, while interesting, contradict the data that is being put out by people who are epidemiological experts and perhaps we should leave the death rate figures to them for now.  I do thank you for your efforts and this has been an interesting discussion.

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1 hour ago, 42pines said:

This was written eight days ago, submitted, but not posted as an article right away.  I did make a more timely post that's the equivalent of this in "News." 

Any article on this subject becomes "dated," almost immediately.  When I posted this Italy was a tiny "blip" on the virus map, now it is the fourth largest "blip."

Let's look at Italy's number's today (3/4 10:18AM)

2502 confirmed cases; 79 deaths and 160 recovered.

There is an "urge" time simply divide deaths by confirmed cases: 79/2502=3.1%, this is the CFR (Case fatality rate).

Yet this number is completely meaningless, and here's why:  Look at cases with "known outcomes" meaning that those afflicted have either died or recovered.

This population is the sum of those who have died + those recovered = 239

Of this population of cases with "known outcome" 79/239 = 33% death rate.

We do not know what will happen to most of the 2502 cases, but we do know that neither all will die, nor all will recover, with no deaths.  This is why we cannot divide deaths/total cases..

Italy now:  Current death rate of cases with known outcomes / 33%

You are correct, currently Italy is a "long way away from a 25% death rate," however it's actually in the direction opposite that you imply.

Over time, predictably, as cases with lesser severity appear, this number will likely fall. 

To sum this up:  It is inappropriate to simply divide deaths by total confirmed cases.  It is more appropriate to divide deaths by the population whose outcome has been defined as dead or survived.

Where on earth are you getting your stats??  They are wildly different from anything by the CDC, WHO etc. Please post link. 

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